Isolated Scalp Laceration in the Elderly: Association Between Age and Red Blood Cell Transfusion Despite Anatomically...

Scalp lacerations without intracranial injury are generally considered anatomically minor traumas. However, elderly patients may experience unexpected clinical deterioration due to persistent bleeding after trivial injury. Such cases may represent clinically urgent conditions when physiological deterioration is taken into consideration. Evidence of the outcomes of isolated scalp lacerations in elderly patients remains limited.

A retrospective analysis of data from the Japan Trauma Data Bank (2019-2023) was conducted. Patients with isolated scalp lacerations, identified using Abbreviated Injury Scale codes, were included. Patients with intracranial injuries or injuries to other body regions were excluded. Patients were categorized into elderly (≥ 65 years) and non-elderly (< 65 years) groups.

Overall, 304 patients were included, of whom 181 (59.5%) were elderly. Elderly patients required red blood cell (RBC) transfusion within 24 h more frequently than non-elderly patients (14.0% vs. 2.6%, p = 0.001). Furthermore, the rate of interhospital transfer after acute trauma management was significantly higher in elderly patients than in non-elderly patients (13.1% vs. 3.4%, p = 0.004). Multivariable logistic regression analyses were performed to identify factors independently associated with RBC transfusion. These analyses demonstrated that age ≥ 65 years (OR 4.540, 95% CI 1.272-16.204) and systolic blood pressure < 90 mmHg on arrival (OR 6.124, 95% CI 2.182-17.186) were independently associated with RBC transfusion.

Advanced age is independently associated with RBC transfusion in patients with isolated scalp lacerations.